Anesthesia - What to Expect

Different Kinds of Anesthesia

If you're having any kind of procedure or surgery, it's understandable to be a
little uneasy. You probably have plenty of questions about everything, including anesthesia — like how the anesthesia is given and
what you will experience.

What happens depends on the type of procedure you're getting and the kind of anesthesia
that will be used, either:

general — in which a person is "asleep"

regional — when one large area of the body is numbed

local — when one small part of the body is numbed

To ease your mind and to help you feel better informed, here's a quick look
at what may happen before, during, and after on the day of the procedure at a hospital
or surgical center.

Before Surgery

Although you may be able to talk to the anesthesiologist a day or two prior to
the operation, you might not meet until that day. Either way, the anesthesiologist
will go over your medical history and information thoroughly, so that he or she can
make the right choice regarding anesthetic medications tailored to your individual
needs.

The anesthesiologist might order additional tests (such as X-rays or blood or laboratory
tests) to help figure out the best possible personalized anesthetic plan for you.

In addition to doing a physical examination of your airways, heart, and lungs,
the anesthesiologist will also want to get your medical history, which will include
asking about:

your current and past health

your family's health

any medications, supplements, or herbal remedies you are taking (consider bringing
a list of exactly what you take, detailing how much and how often)

any previous reactions you or any blood relative has had to anesthesia

any allergies (especially to foods, medications, or latex) you may have

whether you smoke, drink alcohol, or take recreational drugs

Eating and Drinking Before Anesthesia

The anesthesiologist, surgeon, or someone on the nursing staff will give you
instructions about not eating or drinking before surgery. It's important to make sure
you don't eat anything prior to surgery (usually nothing after midnight the day before
the operation). You'll get specific instructions based on your age, medical condition,
and the time of day of the procedure.

Why is eating before surgery an issue? Because the body normally has reflexes that
prevent food from being aspirated (or inhaled) into the lungs when it's swallowed
or regurgitated (thrown up). But anesthetic medications can suspend these reflexes,
which could cause food to become inhaled into the lungs if there is vomiting or regurgitation
under anesthesia.

Sometimes, though, the anesthesiologist will say it's OK to drink clear liquids
or take specific medications a few hours before surgery.

Questions and Answers

To ensure your safety during the surgery, you'll need to answer all of the
anesthesiologist's questions as honestly and thoroughly as possible. Things that may
seem harmless could interact with or affect the anesthesia and how you react to it.

You also can ask plenty of your own questions. If you don't meet the anesthesiologist
before the day of the operation, you may want to ask your doctor or surgeon the following questions
beforehand so you can have all the answers you need:

Is a parent allowed to be with me before surgery? If so, for how long?

Is a parent allowed to be with me while the anesthesia is being given?

What kind of anesthesia will I be given?

How will the anesthesia be administered — with an injection, through an
IV, or with a breathing mask or tube in the throat?

Will I be sedated before the anesthesia is given?

Approximately how long will the surgery take?

Will I still have an IV in or be hooked up to any monitors or equipment after
the surgery is over?

How long will it take me to fully wake up from general anesthesia or feel the
area if local or regional anesthesia was used?

Will I feel pain and/or discomfort (such as nausea or vomiting) after surgery?
If so, how long will it last and what can be done about it?

How soon after the surgery can I see my family?

How soon after the surgery can I go home?

How soon after the surgery can I eat, drink, go to school, or drive?

You might be given a sedative before going into the operating room, but for minor
procedures, this might not be needed. In fact, some people may prefer not to
be sedated. The decision of whether or not to sedate you beforehand is made by
the anesthesiologist, using your input.

In the Operating Room

If general anesthesia is used, the anesthesiologist will start transitioning you
from the normal awake state to the sleepy state of anesthesia. This is called induction,
which is usually done by either injecting medicine through an IV or by inhaling gases
through a mask.

If, like lots of people, you're afraid of needles, the good news is that you may
not have to get one while awake. Anesthesiologists often will begin the induction
process by using a breathing mask to help you relax. The mask delivers medication
to make you sleepy before and during the surgery. That way, you won't be awake when
the IV is inserted for general anesthesia or when a shot is given to numb a certain
part or area of the body for local or regional anesthesia.

When using general anesthesia, the anesthesiologist will monitor your vital signs,
continue to deliver anesthesia, and keep you as comfortable as possible throughout
the operation.

To help you breathe and/or to help deliver general anesthesia during the operation,
the anesthesiologist might use an endotracheal tube (a plastic tube
that's placed into the windpipe through the mouth or nose) or laryngeal mask
airway (or LMA — a mask with a tube that fits into the back of the
mouth).

After Surgery

Once the operation or procedure is over, you'll be taken to the recovery room or
PACU (post-anesthesia care unit). In the PACU, nurses and the anesthesiologist will
monitor your condition very closely to make sure you are making a smooth and comfortable
transition from an anesthetized state to an awakened state.

If you had general anesthesia or were sedated, don't expect to be fully awake right
away — it may take a while and you may doze off for a bit. It usually takes
about 45 minutes to an hour to recover completely from general anesthesia. In some
cases, this period may be a bit longer depending on medications given during or after
surgery.

Although every person has a different experience, you may feel groggy, confused,
chilly, nauseated, scared, alarmed, or even sad as you wake up. Depending on the procedure
or surgery, you may also have some pain and discomfort afterward, which the anesthesiologist
can relieve with medications. When you have recovered from the anesthesia, you'll
be evaluated to make sure you're ready to leave the recovery room.

In many outpatient procedures, people are allowed to come home soon after the surgery
is done. Before you leave the hospital, you'll receive instructions for further recuperation
at home and for a follow-up visit with the surgeon. Talk to the surgeon and/or the
anesthesiologist about what to expect after the surgery and how you can stay as comfortable
as possible.

Anesthesia is very safe. In today's hospitals and surgery centers, highly trained
professionals use a wide variety of modern medications and extremely capable monitoring
technology to ensure that people are stable and as comfortable as possible before,
during, and after their procedure.